Crowson AN, Magro CM
Diltiazem and subacute cutaneous lupus erythematosus-like lesions

N Engl J Med (Nov) 333:1429, 1995

In 4 elderly patients, 2 males and 2 females, each about 75-80 years old, subacute cutaneous eruptions suggestive of lupus were noted. All were light induced. Positive ANA antibodies were found, with anti-RO in 3 and anti-LA in one patient. Although diltiazem had been used for quite some time prior to appearance of the lesions (mean 2.5 years), they resolved after diltiazem was discontinued. Light microscopy in 4 patients and immunofluorescence in 2 was consistent with cutaneous lupus.

Comment: Chlorpromazine, hydralazine, procainamide and quinidine are much more commonly associated with drug-induced lupus. Whether diltiazem was causal in these patients is still an open question. (jtd)

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